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Case Reports
. 2015 Mar;14(Suppl 1):355-9.
doi: 10.1007/s12663-013-0594-4. Epub 2013 Oct 2.

Potentially fatal supramylohyoid sublingual epidermoid cyst

Ujjwal Gulati  1 , Sujata Mohanty  1 , Jayaseelan Augustine  2 , Shalini R Gupta  3
Affiliations
Case Reports

Potentially fatal supramylohyoid sublingual epidermoid cyst

Ujjwal Gulati et al. J Maxillofac Oral Surg. 2015 Mar.

Abstract

A case of chronic and slow growing massive lateral neck swelling is presented which gradually resulted in dysphagia to an extent that patient reported in emergency room. Clinical findings were indicative of a cystic swelling or a massive lipoma. Temporary decompression of the lesion was achieved by partially aspirating the contents of the cyst. Nature of aspirate and its microscopic and biochemical analysis excluded lipoma, vascular malformation and salivary phenomenon. The diagnosis tapered to developmental lateral neck cysts. Magnetic Resonance Imaging (MRI) revealed a massive cystic lesion in the left floor of mouth extending to the right lingual aspect of mandible and posteriorly to impinge on the medial wall of pharynx. A combined intraoral and extraoral approach was used to expose and excise the lesion in toto. Final histological diagnosis of the pathology was epidermoid cyst.

Keywords: Dermoid cyst; Dysphagia; FNAC; Lateral neck swelling.

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Figures

Fig. 1
Fig. 1
a Preoperative frontal view showing lateral neck swelling. b Preoperative intraoral view showing raised floor of mouth displacing the tongue
Fig. 2
Fig. 2
a T1- weighted axial MRI scan showing slightly hypointense signal from a large circumscribed mass in the floor of the mouth. b T2- weighted axial MRI scan showing hyperintense signal from a large well defined mass in the floor of the mouth. c T2-weighted coronal MRI scan showing hyperintense signal from a large well defined mass in the floor of the mouth causing upward displacement of the tongue. d T2-weighted sagittal MRI scan showing hyperintense signal from a large well defined mass in the floor of the mouth
Fig. 3
Fig. 3
a Excised specimen. b Intraoperative extraoral view showing exposure of lesion. c Intraoperative intraoral view showing lesion and left sublingual gland
Fig. 4
Fig. 4
Photomicrograph showing thin flattened hyperorthokeratinized stratified squamous epithelium and a thin collagenous connective tissue wall (H and E, ×100); Inset higher magnification (H and E, ×400)
See this image and copyright information in PMC

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